Search Results

Gain your Certificate in Impression Taking Online with DTL Dental nurses can carry out additional skills under the GDC scope of practice – why not add another skill to your C.V. today? Our course provides the knowledge and the skills needed to take Dental Impressions and Cast Study Models under the prescription of a dentist. It consists of three sections; Online module and assessment Practical competency log sheets – to be completed in your dental practice – no need to attend a class Assignments You can customise the course to your requirements. To include impressions on Dentate, Edenulous and child patients. Your certificate will reflect your choice of patients. You will have access to a tutor The course gives 9 hours of eCPD. All this for just £150 Save more and learn more Combine this course with our Fluoride Application Once you have completed this course, you can complete the Fluoride Application course for a reduced price of £80!! Email training@dentaltrainingltd.com and we can set this up for you. Please note this course is non refundable

Portfolio of Competence You need to take impressions on 15 patients: Option 1 • 10 Dentate Adult Patients • 3 Edentulous Patients • 2 Children (aged up to 16 years) OR Option 2 • 10 Dentate Adult Patients • 5 Children (aged up to 16 years) and Complete the PCS, 2 assignments and the module questions

Personal Protective Equipment Should be provided by your employer and always worn. If you chose not to wear it and something happens then it is entirely your own fault and you cannot sue your employer

Hydrocolloid A hydrocolloid is defined as a colloid system where the colloid particles are dispersed in water. A hydrocolloid has colloid particles spread throughout water, and depending on the quantity of water available that can take place in different states e.g. sol = liquid or gel = jelly like Irreversible or Reversible Hydrocolloid? A sol can be converted into a gel by either • Reduction in temperature = reversible as it can be formed again on heating Or • Chemical reaction = irreversible (Alginate). Composition of Alginate Water and Alginate Setting and Working Times of Alginate Working time – the time allowed for the mixing of alginate, loading the tray and positioning in the patients mouth Setting time – the time that it takes for the chemical reaction to be completed Normal Alginate • Working Time 2 minutes • Setting Time 4½ minutes Fast Set Alginate • Working Time 1¼ minutes • Setting Time 1-2 minutes Items Needed to Take an Alginate Impression Alginate Material Scoop Mixing Bowl Adhesive Water Measuring Device Spatula Trays Patient Correctly Measuring Alginate Correctly Measuring the Water • Always use the water measure provided with the Alginate • Add the water to the marks indicated • 1 measure of water to 1 scoop of Alginate • Adjust the water temperature depending on the speed that you want the Impression to set Manual Mixing of Alginate • Mix the powder and water with the spatula • Do not whip the material as this will incorporate air • Wipe the spatula around the sides of the bowl • Mix until a uniform material and no unmixed powder • Don’t take too long Semi Automatic Mixing Uses a machine to turn the bowl Always make sure that the powder and water are mixed slightly before turning on the machine, otherwise it goes everywhere! Fully Automatic Mixing The powder and water are put in separate containers These are placed into the mixer It is very easy to use and consistently mixes smooth alginate Plastic Bag!?! Put the alginate and water into a plastic bag Mix well Snip a corner off the plastic bag and use it as an icing bag No mess! Stages of Impression Taking 1. Select Tray 2. Try tray into the patients mouth 3. Add adhesive to the tray 4. Mix the Alginate 5. Place the Alginate into the tray 6. Insert the tray into the patients mouth 7. Hold until set 8. Break the seal and remove the set impression and tray 9. Check the impression 10. Disinfect impression Explain to the patient what is going to happen • The material will feel cold, there will be no unpleasant taste and the material will set quickly • Once the impression has been placed in their mouth they should breath deeply through their mouth to help them relax • Wiggle their legs if they start to gag – this distracts them • Advise them to use hand signals if they are uncomfortable Where to stand whilst taking the impression Lower Impressions • You should stand in front of the patient with your elbow below the patients mouth height Upper Impressions • You should stand behind the patient with your elbow at the same level as the patients mouth Make Sure the Chair is Correctly Adjusted Inserting the Impression Tray • The trays should be inserted sideways into the patients mouth • They should then be rotated into the correct position before seating them into the correct position • Make sure that the patient is relaxed – it is easier to control soft tissues and lips • Always ensure the lip is out of the way before seating the impression • For lower impressions the patient must raise their tongue and more it from side to side and then relax it forwards onto the tray Ensure Disinfection of Impressions • Impression should be rinsed under running water to remove all traces of saliva and debris • Place the impression in a disinfectant bath for 10 minutes • Rinse again • Place in damp gauze • Place in a labelled bag – labelled as disinfected • Cast within 1 hour

Aims and Objectives • To ensure that all dental nurses are competent in taking Impressions on patients under the prescription of the dentist • Understand the importance of cross infection control and Health and Safety when taking impressions • Know the reasons why impressions are taken • Understand why medical history is so important and what to do in the event of a medical emergency • Complete the assessment at the end of the module • Complete and submit the completed portfolio of competence – this can either be done via email or post (please send by registered post) *we cannot beheld responsible if work is lost in the post. • Complete the two assignments

The Anatomy and Structure of the Tooth Deciduous Dentition Also known as milk, temporary, baby or primary teeth • Total 20 – 10 in each jaw • Begin developing before birth • Smaller than permanent teeth • Whiter than permanent teeth • Larger Pulp chamber than permanent teeth • Thinner enamel than permanent teeth • Roots absorbed by permanent teeth, when they loosen and fall out = Exfoliation • Roots of deciduous teeth spayed out to accommodate the permanent teeth, roots are described as divergent. Permanent Teeth • Total 32 – 16 in each jaw • Begin developing around time of birth • Larger than deciduous teeth • Darker than deciduous teeth • Smaller Pulp chamber than deciduous teeth • Begin erupting at around 6 years of age • All except third molars are usually present by the age of 13 • Deciduous molar teeth are succeeded by permanent premolar teeth Enamel • Harder than bone – hardest substance in body • 96% inorganic mineral crystals arranged as prisms in an organic matrix called interprismatic substance • Main crystals are hydroxyapatite • Prisms lay at right angles to the junction with the next tooth layer – Dentine • The junction between enamel and dentine is called the amelodentinal junction(ADJ) • No nerves/blood vessels – no pain Dentine • Lies beneath the enamel, forming most of the tooth • 80% inorganic • Composed of hollow tubules containing fibrils – sensory endings – pain • Secondary dentine causes pulp chamber to narrow & decrease in size gradually • Repairs itself by forming secondary dentine • Formed by odontoblast cells lying at the edge of the pulp chamber • Secondary dentine also forms part of the ageing process • Yellowish in colour and slightly elastic • Caries progresses rapidly through the dentine due to the hollow tubules Pulp • Allows tooth to feel hot, cold, touch & pain by sensitisation of the fibrils • Contains sensory nerves and blood vessels – purely soft tissue • The blood vessels enter through apical foramen • Enclosed within the pulp chamber which is lined by odontoblast cells • The pulp chamber narrows with age and may become blocked by pulp stones Cementum • Covers the dentine of the root • Normally lies below the gingivae • Allows attachment of the tooth to the supporting structure of the periodontal ligament • Thickness varies at different parts of the root • Thickness changes throughout life Incisor Teeth • Largest is upper central incisor • Smallest is the lower central incisor • They have chisel shaped crowns • One Root • The palatal surface of the upper incisors is often raised as a mound of enamel which is called the Cingulum • The incisal edge is used to cut the food Canine Teeth • Conical Crown • Pointed incisal edge • Upper canine is larger than the lower • They have one root • Upper canine has the longest root of the dentition • Used to cut and tear food Premolar Teeth • 2 cusps - buccal-palatal or buccal- lingual • Upper premolar cusps are of equal size, but lingual cusps of lowers are smaller than their buccal cusp • Upper first premolar has 2 roots buccal & palatal • All other premolars have 1 root • Used to tear and chew food Molar Teeth • Upper 6s may have 5 cusps – fifth smaller is a smaller cusp called the cusp of Carabelli • Lower 6s has 5 cusps, 3 buccal and 2 lingual • All other molars have 4 cusps of similar size • Large occlusal surface for grinding and chewing food • Upper molars have 3 roots, palatal, mesial- buccal and distal-buccal arranged as a tripod • Lower molars have 2 roots – mesial and distal

Medical Emergencies In the Dental Practice • Faint • Choking • Respiratory arrest • Hyperventilation • Asthma • Anaphylaxis • Seizures • Hypoglycaemia • Cardiac emergencies • Angina • Myocardial infarction • Cardiac arrest • Stroke • Adrenal insufficiency Faint Caused by a sudden temporary loss of consciousness that usually results in a fall. When you faint, you'll feel weak and unsteady before passing out for a short period of time, usually only a few seconds. There may not be any warning symptoms, but some people experience: • yawning • a sudden, clammy sweat • feeling sick (nausea) • fast, deep breathing • confusion • light-headedness • blurred vision or spots in front of their eyes • ringing in their ears Treatment for a Faint If someone is feeling faint, ask them to lie down Kneel down next to them and raise their legs Watch their face for signs of recovery or the condition worsening Make sure that they have plenty of fresh air – ask someone to open a window or turn on air conditioning. Reassure the casualty and help them to sit up slowly when they are feeling better. Give glucose to help maintain their blood sugar If their condition worsens call for an ambulance If the casualty recovers fully and hasn’t suffered any injuries, there is no need to call an ambulance. If they are not sure what caused the faint, or haven’t fainting before then it is advisable for them to seek medical attention. Occasionally, a faint can be the sign of a more serious underlying medical condition. Hyperventilation There is more air passing through the chest than the body can deal with it, often caused by stress or over-excitement. Symptoms: unnaturally fast deep breathing anxiety dizziness trembling or tingling in the hands muscle cramps in the hands and feet Treatment • Do not give oxygen. • Speak to them firmly, but be kind and reassuring. • If available ask them to breath in and out of a paper bag if none is available they need to concentrate on their breathing. Asthma Attack Affects the airways – they narrow on exposure to inhaled particles causing swelling and spasm, a condition of hypersensitivity. Some triggers can be recognised (allergy – hay fever), can also be a response to stress or fear. The usual symptoms of asthma include: • wheezing • coughing • shortness of breath • tightness in the chest. Treatment Reassure patient, give salbutamol from emergency drugs kit and oxygen if necessary. Wait 3 minutes then give more salbutamol if after 5 minutes no recovery dial 999 Anaphylaxis Anaphylaxis usually develops suddenly and gets worse very quickly. The symptoms include: • feeling light headed or faint • breathing difficulties – such as fast, shallow breathing • wheezing • a fast heartbeat • clammy skin • confusion and anxiety • collapsing or losing consciousness • There may also be other allergy symptoms, including an itchy, raised rash (hives), feeling or being sick, swelling or stomach pain Treatment for Anaphylaxis • Call 999 for an ambulance immediately – mention that you think the person has anaphylaxis • Use an adrenaline auto-injector– but make sure you know how to use it correctly first • Remove any trigger if possible – for example, carefully remove any wasp or bee sting stuck in the skin • Lie the person down flat – unless they're unconscious, pregnant or having breathing difficulties • Give another injection after 5-15 minutes if the symptoms don't improve and a second auto-injector is available Epileptic Seizure A seizure is caused by the electrical activity within the brain being interrupted, can be due to a head injury during their lifetime • stay calm. • make sure the area is safe. • note the time the seizure starts. • cushion their head with something soft if they have collapsed to the ground. • don't hold them down, or put anything in their mouth. • if a seizure doesn't stop after 5 minutes, call for an ambulance (dial 999). After the seizure has stopped, they will be very tired and will need assistance getting home. Hypoglycaemia Hypoglycaemia occurs when the level of glucose present in the blood falls below 4 mmol/L (72mg/dL), this can be tested with the blood glucose monitor in the emergency medical kit. Treatment • If patient is conscious give glucose • If unconscious give glucagon from first aid box • Maintain airway • Give oxygen • If no recovery dial 999 Cardiac Emergencies All cardiac problems present with similar symptoms, they can be triggered by stress and anxiety. Ask patients to sit down if it is angina the pain will go with rest Treatment • Angina GTN spray under tongue • Aspirin may be given by the dentist • Call 999 if condition deteriorates Stroke Sudden and serious impairment of blood supply to the brain, affects older patients and those with hypertension or other circulatory disorders. Remember: Face Speech Arms Time to call an ambulance Adrenal Insufficiency Long term administration of oral corticosteroids, hypotension (low blood pressure) when under physiological stress. Patient has problems keeping awake Very rare best to consider all other possibilities before diagnosing Can be avoided by asking patient to double morning steroid dose after consulting with doctor

Safeguarding of Child and Vulnerable Adults We are obliged to inform the appropriate authorities if we suspect any form of abuse This must be done in accordance with local policies and procedures

Communication We need to think how we are explaining things with the patient - ‘We need to ensure that the impression captures the maxillary tuberosity We know what this means but our patients will not - make sure that we say the back of the teeth Demonstrate to the patient on a model so that they know exactly what is going to happen

Impression Taking Impressions are used to record the shape of the teeth and alveolar ridges There are a wide variety of impression materials available Impressions are negative reproductions of dental structures and can be used for: Study Casts orthodontics, erosion cases, treatment plans Extra-coronal restorations - crowns, bridges, inlays, implants Dentures full or partial Splints, occlusal, mouth guards Maxillo-facial prosthesis obturators Impressions must Accurately record • Teeth, size, position, number, shape, occlusal morphology • Soft tissue contours • i.e. Gingivae • Soft tissue reflections • Spaces and voids - Be dimensionally stable - Capture undercuts - Have high tear strength Classification of Impressions Preliminary Impression: • Used to make a reproduction of the teeth and surrounding tissues Final Impression: • Taken by the dentist • Used to make the most accurate reproduction of the teeth and surrounding tissues • Used to make indirect restorations, full or partial dentures and implants Qualities of the Ideal Impression Material • Impression material must be • Non irritant • Non toxic • Clean to use • Acceptable taste and smell • Long shelf life – 1year + • Reasonably cheap • Easy to mix • Dimensionally stable • Resist distortion on casting • Chemically compatible The Ideal Patient • Ability to open wide • No Gag reflex if they have a gag reflex use a distraction technique like wiggling their big toe • Ensure they have no allergies • The patient should feel comfortable in the dental chair, probably most comfortable position is sitting upright Setting and Removal of the Impression from the Mouth Disadvantages of Alginate Materials needed to take an Impression Impression Trays How to select a tray The tray should: • Feel comfortable for the patient • Extend slightly beyond the facial surfaces of the teeth • Extend 2-3mm beyond the third molar, retromolar or tuberosity area of the arch • Be deep enough to allow 2-3mm of material between the tray and the occlusal or incisal edges of the teeth Extending the Impression Tray Tray Adhesion Impression Materials Can be: Rigid when set Records details when no undercuts are present Or Elastic when set Records details of oral tissues when undercuts are present Elastic Impression Materials